The invention relates to a method and an instrument for inserting a tuck of iris tissue between clamping arms of an intraocular device to be attached to a surface of the iris in an anterior chamber of an eye. The invention also relates to an ophthalmologic implant to be attached by pinching a tuck of iris tissue.
In U.S. Pat. Nos. 4,215,440 and 5,192,319 intraocular lenses are described which are to be implanted in the anterior chamber of the human eye by clamping a tuck of iris tissue between pincher-like arms projecting from an optical portion of the lens.
Advantages of attaching an intraocular lens to a plea of iris tissue are that the iris does not need to be perforated, that no parts of the lens project through the iris, that the attachment can be made quickly and with few manipulations, and that the attached lens is also secured against rotation about its optical axis. Forming a tuck of iris material is carried out by stroking iris tissue into a tuck and by bringing the tuck between ends of pincher-like arms projecting from the optical portion of the lens by, at the same time, pushing one of the clamping arms away from the iris relative to the other clamping arm so that the iris opens up. Although many eye surgeons routinely perform this technique, it requires special skill and training.
It is an object of the present invention to provide a solution which facilitates the formation of a tuck of iris tissue and the introduction of that tuck between the clamping arms of the implant.
According to the invention, this problem is solved by providing a method for attaching an intraocular implant having pincher-like clamping arms forming a pinching area between the clamping arms to an iris of an eye, including: positioning the implant against a surface of the iris in the anterior chamber; positioning a passage in a distal end portion of an ophthalmologic surgical instrument in the anterior chamber against the surface of the iris closely adjacent the pinching area; and applying suction to the passage and urging at least one of the end portions of the clamping arms towards the iris, causing a tuck of iris material adhered to the passage to be inserted into the pinching area.
The invention further provides an ophthalmologic surgical instrument for inserting a tuck of iris tissue in a pinching area between clamping arms of an intraocular implant to be attached to a surface of the iris in an anterior chamber of an eye, including: an elongate distal end portion for insertion into the anterior chamber, the distal end portion generally extending in an axial direction and comprising a laterally facing entry passage in a distal tip section of the distal end portion, the passage having an entry area bounded by a rim extending in a single plane for sealingly contacting the iris tissue surface and a crest facing away from and extending essentially parallel to the plane, for urging open the pinching area between the clamping arms, and a conduit extending from the passage for transferring a vacuum to the passage from at least a more proximal portion of the instrument. Such an instrument is specifically adapted for carrying out the method according to the invention.
Since the iris material is adhered to the passage of which the rim essentially sealingly contacts the iris tissue surface, a tuck adhering to the passage can easily be introduced into the pinching area between the clamping arms which are urged towards the iris by passing the crest of the distal end portion through pinching area between the clamping arms. The iris material follows the crest so that a tuck of the iris tissue is inserted between the clamping arms.
The invention further provides an intraocular implant having pincher-like clamping arms for engaging a tuck of iris tissue for attaching the implant to the surface of the iris in an anterior chamber of an eye, the pincher-like clamping arms projecting from a central portion of the implant, and defining a pinching area in a position spaced from the central portion, a gap being enclosed by the central portion and the clamping arms, the central portion having a positioning spot for positioning a tip of an ophthalmologic instrument in a position opposite across the gap of the pinching area between the clamping arms. Such an implant is specifically adapted for use in combination with an elaboration of the invention in which the clamping arms are urged towards the iris by the distal end portion of the instrument exerting a force towards the iris on a central portion of the implant while the crest thereof is passed through the pinching area between the clamping arms in a direction away from the implant. To facilitate keeping the tip of the distal end portion of the instrument exerting a force on the implant in a position relative to the implant, and thereby facilitate control over the position of the implant prior to its complete attachment to the iris, the implant is provided with a positioning spot for positioning the tip of the ophthalmologic instrument. This spot is engaged by the tip of the ophthalmologic instrument and makes it less prone to slipping over the surface of the implant.
Particular elaborations and embodiments of the invention are set forth in the dependent claims.
Further features, effects and details of the invention appear from the detailed description and the drawings. In the brief description, the orientation of views refers to an orientation of the eye and surgical instruments where the anterior side of the eye is facing vertically upwards.